The impact of ACE inhibition on all-cause and cardiovascular mortality in contemporary hypertension trials: A review
The renin-angiotensin-aldosterone system is a key therapeutic target in hypertension. The latest meta-analysis of mortality reduction with angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) in hypertension features 158,998 patients from 20 contemporary hypertension trials. ACE inhibitors and ARBs significantly reduced relative risk for all-cause mortality by 5% (p = 0.032) and cardiovascular mortality by 7% (p = 0.018) in populations with a high prevalence of hypertension (≥66%). ACE inhibitors produced a 10% reduction in relative risk for all-cause mortality (p = 0.004) and a trend toward a 12% reduction in cardiovascular mortality (p = 0.051), whereas ARBs had no effect. On balance, mortality evidence suggests that in hypertension, ACE inhibitors should be considered ahead of ARBs, and ARBs restricted to patients intolerant of ACE inhibitors.
|Keywords||ACE inhibitor, all-cause mortality, angiotensin II, ARB, bradykinin, cardiovascular mortality, hypertension, meta-analysis|
|Persistent URL||dx.doi.org/10.1586/erc.13.42, hdl.handle.net/1765/70436|
|Journal||Expert Review of Cardiovascular Therapy|
Ferrari, R, & Boersma, H. (2013). The impact of ACE inhibition on all-cause and cardiovascular mortality in contemporary hypertension trials: A review. Expert Review of Cardiovascular Therapy (Vol. 11, pp. 705–717). doi:10.1586/erc.13.42